Cosmetic surgery is perceived as less risky with a shorter recovery time and less pain than plastic or reconstructive surgery, according to an article in the September issue of The Archives of Facial Plastic Surgery, one of the JAMA/Archives journals.

"Historically, a thorough preoperative evaluation for cosmetic surgery included routine psychiatric consultation. A sea change has occurred over the last 40 years regarding the concept of deformity and suitability for surgery, and now most patients seeking cosmetic procedures are considered to be good candidates," according to background information in the article. "This shift in attitude, coupled with the popularity of reality makeover shows, has increased public exposure and demand for cosmetic surgical procedures."

Grant S. Hamilton III, M.D., of the University of Iowa Hospitals and Clinics, Iowa City (now at the University of Illinois at Chicago), and colleagues explored public perception of the terms "cosmetic," "plastic," and "reconstructive," as they relate to surgery. In April and May of 2003, the researchers surveyed 216 people in person and via the internet, aged 18 years or older, assessing their opinions of surgical variables such as permanence, risk, expense, recovery, reversibility, pain, technical difficulty, and surgeon training. Of those surveyed, approximately 66 percent were women and 82 percent were from the midwestern United States.

The authors state: "Cosmetic surgery is perceived to be more temporary and less technically difficult than plastic or reconstructive surgery. In addition, cosmetic surgery is believed to be associated with less risk, shorter recovery time, and less pain. Subjects also thought that cosmetic surgeons required significantly less training than plastic or reconstructive surgeons."

Survey respondents found little difference in perception between 'plastic surgery' and 'cosmetic surgery' when asked about cost. They also seemed less likely to underestimate the dangers and discomfort of plastic surgery

The authors conclude: "Perhaps it is time for plastic surgeons--whether generalists or specialists in the head and neck--to reemphasize the term 'plastic,' as it more accurately defines both the surgery and surgeon."